FSA-2450 Temporary Amendment - consent to payment of proceeds fro

Form Approved – OMB No. 0560-0236

This form is available electronically.

(See Page 2 for the Privacy Act and Paperwork Burden Statements.)

FSA-2450 (12-31-07)

U.S. DEPARTMENT OF AGRICULTURE Farm Service Agency

Position 1

TEMPORARY AMENDMENT OF CONSENT TO PAYMENT OF PROCEEDS FROM SALE OF FARM PRODUCTS

PART A – ACCEPTANCE BY PURCHASER

1A. Purchaser's Name and Address      

1B. Purchaser's Telephone Number      

1C. Signature of Purchaser

1D. Title of Purchaser      

1E. Date Signed      

PART B – SELLER (BORROWER)

2A. Seller's (Borrower) Name and Address      

2B. Seller's (Borrower) Telephone Number      

PART C – FSA USE ONLY

3. Please refer to

FSA-2042, Consent to Payment of Proceeds from Sale of Products (Consent) or

FSA-2043

Assignment of Proceeds from the Sale of Dairy Products and Release of Security Interest (Assignment), executed by the subject

borrower, purchaser, and FSA, dated (a)

     

.

FSA agrees that said Consent or Assignment is amended, for a temporary period beginning (b)

     

and ending (c)

     

, to allow payments as follows:

TO FSA:

(d) $

     

of the purchase price, or

(e)

     

% of the purchase price figured to the nearest dollar,

payable (f)

     

(Weekly, Monthly, etc.)

TO Borrower:

(g)

any remaining balance of the purchase price.

After the end of such temporary period, payments will again be subject the Consent or Assignment referred to in Item 3 above of this amendment.

4A. FSA County Office Name and Address      

4B. FSA County Office Telephone Number      

4C. Signature of Agency Official

4D. Title of Agency Official      

4E. Date Signed      

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual's income is derived from any public assistance program. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

FSA-2450 (12-31-07) Page 2

Note:

The following statements are made in accordance with the Privacy Act of 1974 (5 USC 552a), the Farm Service Agency (FSA) is authorized by the Consolidated Farm and Rural Development Act, as amended (7 USC 1921 et seq.), or other Acts, and the regulations promulgated thereunder, to solicit the information requested on its application forms. The information requested is necessary for FSA to determine eligibility for credit or other financial assistance, service loans, and conduct statistical analyses. Supplied information may be furnished to other Department of Agriculture agencies, the Internal Revenue Service, the Department of Justice or other law enforcement agencies, the Department of Defense, the Department of Housing and Urban Development, the Department of Labor, the United States Postal Service, or other Federal, State, or local agencies as required or permitted by law. In addition, information may be referred to interested parties under the Freedom of Information Act, to financial consultants, advisors, lending institutions, packagers, agents, and private or commercial credit sources, to collection or servicing contractors, to credit reporting agencies, to private attorneys under contract with FSA or the Department of Justice, to business firms in the trade area that buy chattel or crops or sell them for commission, to Members of Congress or Congressional staff members, or to courts or adjudicative bodies. Disclosure of the information requested is voluntary. However, failure to disclose certain items of information requested, including Social Security Number or Federal Tax Identification Number, may result in a delay in the processing of an application or its rejection. According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0560-0236. The time required to complete this information collection is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. RETURN THIS COMPLETED FORM TO YOUR COUNTY FSA OFFICE.